수술 전 갑상선 암의 측경부 림프절전이 예측을 위한 지수화된 전산화 단층촬영 소견의 임상적 의의

The Clinical Significance of Scored CT Findings for Pre-operative Prediction of Lateral Cervical Lymph Node Metastasis in Thyroid Cancer

<B>Purpose:</B> Although ultrasound is routinely used for pre-operative evaluation of neck nodes in patients with papillary thyroid carcinoma, CT is also widely used. We designed a prediction score of lateral cervical lymph node metastasis (PSLCNM) for improving diagnostic ability of CT. The purpose of our study was to determine the clinical significance of the PSLCNM. <P><B>Methods: </B>A total of 124 patients with thyroid carcinoma who underwent surgery of lateral cervical lymph node dissection after pre-operative CT evaluation were enrolled in this study. We retrospectively evaluated the diagnostic ability between CT findings by one radiologist and PSLCNM for prediction of lateral lymph node metastasis. <P><B>Results:</B> In terms of predicting lateral cervical node metastasis, the positive predictive value of CT findings of indeterminate, suspicious, or metastatic nodes were 37.5% (21/56), 68.3% (28/41), 85.7% (18/21). Those of 1, 2, 3, 4 in sum of PSLCNM were 34% (16/47), 60% (30/50), 91% (10/11), 100% (10/10). <P><B>Conclusion:</B> Prediction of lateral cervical node metastasis using PSLCNM showed a better result than conventional CT findings and could decrease unnecessary surgical procedures and postoperative complications in the surgery of thyroid cancer. <B>(Ko</B><B></B><B>rean J Endo</B><B>crine Surg 2011;11:81-85)</B>